Sudden deaths of patients who were medicated with high dosages of neuroleptics -. Reports are available from Simpson et al (1987), Mehtonen et al (1991) and Thompson. (1994).

UK, there were thirteen sudden deaths of patients who were medicated with Pimozide.

Thomas (1997) refers to the death of Orville Blackwood in 1991 from heart failure, which resulted from being injected with a cocktail of Promazine and Fluphenazine.

Whitaker (2002): reports 20 people died whilst taking Olanzapine out of 2,500.

EXTRA PYRAMIDAL SYSTEM IN THE BRAIN

This system is implicated by neuroleptics and pertain particularly to abnormal body movements. They include: Extra Pyramidal Side Effects, Tardive Dyskinesia, Tardive Dystonia andAkathesia - the latter is included in the psychological side effects section as the emotions are highly negatively implicated. All three iatrogenic conditions are thought to stem from the brains dopamine nigrostriatal pathway due to the blocking of dopamine by neuroleptics.

1. Extra pyramidal side effects (E.P.S.)

Discovered in 1954, these side effects result from the neuroleptic prescribing - the patient displays Parkinsonion symptoms.

Fine body tremor, which ranges from being almost imperceptible to incessant shaking.

Bradykinesia- the slowing down of large muscle movement so that the patient appears stupid and/or clumsy.

Unresponsive to everyday situations going on around them.

Flat, vacant expression.

Zombie appearance

Excessive salivation

EPS are more prominent with typical neuroleptics

To combat the EPS side effects, anti-cholinergic drug,which are alsoprescribed for Parkinson's disease, have their own side effects.

1a Anticholinergic Side Effects

A. Within the Peripheral Nervous System (Leiberman 2004)

Blurred vision

Headaches

Dry eyes

Dry mouth

Increased heart rate

Difficulty in urinating

Constipation

B. Within the Central Nervous System (Lieberman 2004)

Impaired Concentration

Confusion

Attention deficit

Memory impairment

Several studies have indicated that long-term neuroleptic use is associated with cognitive deterioration and atrophy of the brain. Chronic use of neuroleptics precedes Parkinson's disease.

2. TARDIVE DYSKINESIA (TD)

Grossly disfiguring and include:

The lower jaw moves in sideways movement.

The lips become pursed with the patient sucking and smacking of the lips.

Blowing in and out of the cheeks.

Facial grimacing.

Abnormal tongue movements i.e. the tongue quivers - protrudes

Finger movements as though an invisible guitar is played.

Body actions are involuntary, potentially irreversible and there is no proven treatment

Shrinkage of adrenal glands creates decreased ability to use body fat for energy.

Increased appetite

2. Diabetes

Excessive thirst is one symptom

Cortisol imbalance - hyperglycaemia

Increasing insulin resistance (Pao et al 2007)

Duke University issued a report (2002) identifying:

289 cases of diabetes in patients who had been prescribed Olanzapine. These researchers stated: "Of the 289 cases of diabetes linked to the use of Olanzapine, 225 were newly diagnosed cases. 100 patients developed ketosis (a serious complication of diabetes).22 patients developed pancreatitis – potentially life-threatening condition. 23 deaths, including that of a 15-year-old adolescent who died of necrotising pancreatitis, a condition where the pancreas breaks down and dies. 71 % occurred within six months of starting the drug and many cases were associated with moderate weight gain."

1994Duke University team first reported a diabetes link with Clozapine.

This is a potentially fatal condition of neuroleptic prescribing and can be associated with rapid and large increases in neuroleptic dose and also in conjunction with other neuroleptics (polypharmacy). Occurs in 3% of people with a predominance towards men.Mortality rates for NMS 6%. (Benzer 2002); 30% mortality rate (The Merk Manuals)

Osteoporosis has also been connected with hyperprolactemia and a vulnerability to hip fractures. Neurolepticed males have been found to have reduced bone density (Hummer et al 2005) and therefore have the potential for osteoporosis. Increased levels of cortisol (Annals of Internal Medicine 2005) was found in patients with osteoporosis and may possibly be the cause of neuroleptic induced osteoporosis.

Females have been found to have loss of bone mass. (PurificaciÃ³n Rey-SÃ¡nchez 2009)